


St. Elsewhere's Other Face of Autism- A Look at Victor Ehrlich

by AnnetheCatDetective



Category: St. Elsewhere
Genre: Autism Spectrum, Essays, Meta, Other
Language: English
Status: Completed
Published: 2018-12-13
Updated: 2018-12-13
Packaged: 2019-09-17 10:42:47
Rating: Not Rated
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 4,408
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/16973091
Author URL: https://archiveofourown.org/users/AnnetheCatDetective/pseuds/AnnetheCatDetective
Summary: He's just really, really autistic, you guys. I have laid out the evidence, with all the insight of an autistic adult who also lives with an autism assessment expert.





	St. Elsewhere's Other Face of Autism- A Look at Victor Ehrlich

**Author's Note:**

> I may or may not feel it necessary to update this with another chapter covering later seasons. I lay out evidence almost entirely from s1, which is the only season on DVD, but the whole thing is on I want to say hulu and also youtube. I would really encourage people to watch it!

St. Elsewhere is the source of one of TV history’s first and most famous canon autistic characters in Tommy Westphall, but the moment we met Victor Ehrlich, I recognized in him the kind of autism that wasn’t recognized in 1982, that wasn’t really recognized even a decade later-- a sometimes stiff and awkward or clumsy adult, intellectually gifted, with one or two all-consuming passions, with some enormous gaps in social ability. Another face of autism, and one that many of us in a modern audience find more familiar than Tommy Westphall.

 

I’m writing up my ‘evidence’ season by season as I watch and basing this on s1, so there may be updates in the future if I see something in a later season so compelling as to require a second chapter of meta. I’ll be going over the things which I recognize as autistic traits, and how I read his character. I’ll be covering his social skills and abilities (and gaps therein), body language and mannerisms, and special areas of interest.

  
  


\---/-/---

 

I. ABILITY

As is common for individuals on the autism spectrum, Victor Ehrlich’s abilities are spread out in some unusual ways. Not only do Normal Adult Abilities not necessarily group together as they do in neurotypicals, but overall ability can be wildly affected by factors like stress, so that the thing Victor was good at yesterday may not be something he can do today, etc. 

 

The number one factor in Victor’s main ability-- that to perform surgery, something he was top of his class for-- is the stress of being yelled at by Dr. Craig. We know that Victor is intelligent and capable, and that he continually brushes up on his studies during his residency. Victor is seen studying over his lunches or even just in the hallways more than any other character, and with our knowing about his class placement, it’s not because he needs to catch up. He doesn’t seem to find it dull, and only finds studying stressful when he’s thinking about the possibility of Dr. Craig picking on him later. We see him knowing the material and then blanking completely when under pressure-- not the pressure of life and death in the surgery suite, but the pressure of being yelled at.

 

He’s also affected by sleep deprivation, and by other stressors, but fear of Craig yelling at him or seeing him as not smart enough is number one. It’s not only the ability to give quiz answers, either-- he becomes more physically clumsy as well. We know Victor is not physically clumsy across the board-- he’s a surfer, has taken ballroom dancing lessons and seems (when not under duress) to be physically confident and competent. He doesn’t engage many team sports, but does play handball. He cares about and enjoys these things, they reduce his stress, and so he can perform well, but his coordination seems to drop when he’s under duress. 

 

Speaking of physical coordination varying wildly, this man does not eat spaghetti with the coordination of a surgeon. His handling of silverware is at times awkward and even child-like. And the thing is, we see him in surgery, we know he’s good with his hands--  _ at _ surgery! But as with many autistic people, it’s not only a potential gap between gross and fine motor coordination, but gaps between different tasks requiring fine motor-- think of an artist who can create beautiful, intricate work but has a second grader’s handwriting, or perhaps a person with neat handwriting and difficulty manipulating small objects. Being able to freehand embroider but not tie your shoes. These mismatches in ability show up a lot on the autism spectrum. With both gross and fine motor coordination, Victor is capable of very difficult things, and clumsy and awkward with those a typical person might find to be the easier task (and while he claims to be a capable ballroom dancer-- something we don’t get to see him follow through on, sadly-- he’s stiff and awkward when it comes to dancing at a party).

 

Just as there are gaps between different physical skills, we know that while Victor has an excellent memory for medical knowledge-- and quite probably for trivia-- he can be forgetful when it comes to other areas. Despite being a surgical resident on the path to a promising medical career, a man who cooks for himself and keeps a clean home for himself and is apparently  _ exacting _ in his bookkeeping, when someone else calls on him to be the Responsible Adult in a situation, he is not comfortable. There are parts of Victor’s personality that do enjoy having control, it’s not that he doesn’t want to be an adult or that he constantly requires others to take care of him, rather that he hasn’t quite learned to be the kind of adult who might be in charge of a situation outside of the surgery, or responsible for other adults.

 

Also, the guy makes himself throw up out of sheer stress. Not that this can’t happen to neurotypical people, but there’s a huge correlation between mental stress and physical health (especially digestion-related) in the autistic population, and I absolutely felt for him in that moment. 

 

The fact that he doesn’t drive may have more to do with student loans than ability, we only know he doesn’t have a car, not that he doesn’t have a license, but I felt it worth mentioning as a potential other area in which his adult experience fails to match up to that of his peers.

 

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II. SOCIAL

 

Throughout season one, Victor is out of step, socially. A lot of his problems seem to stem from misunderstanding-- from missing social cues, from trying to ape social behaviors at inappropriate moments. He’s social-seeking in many ways, he wants others to like him and he wants to be seen as a certain type of guy, but that doesn’t mean he seeks out every social situation, either-- he’s often uncomfortable with social situations that aren’t familiar to him. 

 

The fact that Victor often tries to copy social behaviors without a root understanding of why others say certain things or when it’s appropriate to say them is familiar to a lot of autistic people. But where Victor sees others being successful with this kind of thing, he tries to talk like ‘one of the guys’ from an un-genuine place and often suffers social repercussions for it, rather than being slapped on the back and palled around with. One example early on is when a couple of the other doctors are jokingly betting on Auschlander’s odds of surviving his cancer-- Victor, trailing a step or two behind physically despite his stride, and trailing a good few steps behind where social acumen is concerned, suggests a betting pool, at which point the others tell him he’s sick. He hasn’t been particularly nastier than either of the other parties, but is singled out in the conversation for difficult to parse reasons.

 

Several times over the course of the season, Victor’s attempts at being friendly seem to bother others, whether it’s full-on irritation or just a weary sigh and a ‘moving on’, he has a hard time making those connections, even among friends. It’s not that the other doctors don’t like him-- for the most part, they do! They value him, and it’s not that they don’t enjoy his company, but there are times when even those closest to him don’t really know what to  _ do _ with him. It’s not always being called out for a tasteless remark when the other guys can be worse-- especially in s1 as opposed to s2, he often just seems to be out of step in more subtle ways. Even in s1 he does engage in some of the Laddish talk, but it seems very un-genuine coming from him-- he’s putting on the act of being the kind of man he thinks his friends are and that he thinks society prefers him to be. 

 

There’s also moments of this sort of… not quite age-appropriate social behavior? Not big, childish behaviors (outside of his friend-breakup with Fiscus and their refusing to speak to each other except through a third person), but subtle moments of just not quite being an Adult about things. Of getting frustrated by things too easily the way you do when you can’t develop emotional distance, or moments where it seems as though he expects to be treated like a child and starts to behave accordingly, such as when he’s being lectured or disciplined. Not a full-blown childishness, not the losing of his adult ability and mindset by any means, but the sense that there is part of him which hasn’t developed on track with the rest of him, which falls into these places. Plus, he literally pulls the old ‘so I have this  _ friend _ ’ out, and in such a transparent tone (and yet is impressed with Vijay’s insight in seeing through his clever ruse?).

 

He gets very agitated over chit-chat and interruptions when playing games. For others, the chatting is part of the pleasure of playing cards and board games, for Victor, the game is an enjoyable activity, but the non-game talk is upsetting, distracting. It draws things out when the focus should be on the Shared Activity rather than the cross-talk. It’s not that he doesn’t like playing with others-- though there may be some social pressure involved in his joining in the poker games, the game of Trivial Pursuit is his, and is something he’s clearly very invested in despite there not being a bet riding on it to worry about. It’s still a social activity to him, and he still enjoys having the company of the people he’s playing with, but he has a hard time if the focus moves away from the game itself.

 

And speaking of social pressure… Victor is very susceptible to it, and to suggestion. He’s naive and he’s needy, and there’s a lot he’ll do if manipulated, but also, he just has a tendency to believe what he’s told. He takes advice without examination, accepts things he’s told in a voice of authority as being a new Rule, and is on occasion ready to accept something he’s told over something he personally knows to be true, if it’s stated with enough conviction to give him doubt. 

 

Victor trades favors and rearranges shifts to avoid going to a party. I really don’t have a better opening to this paragraph than this plain and simple fact. He goes to enormous lengths to not have to go to a party. No non-autistic person has ever tried as hard as Victor Ehrlich to not attend a party. Especially as it was in honor of a visiting world-famous surgeon, and if there’s one thing Victor cares about, it is surgery. Not only does he desperately not want to go to a party hosted by the man he most admires, feting another no-doubt-well-admired surgeon, he’s hopeless when it comes to finding a date for it. It isn’t only that most women don’t want to go out with him-- although considering his attempts at Laddishness, they’re not wrong when they do refuse him-- it’s that he’s incapable of catching social cues that would indicate actual interest. When he does arrange a date with a friend, he winds up missing every single social cue she sends him that evening, behaving badly to her, and making a general fool of himself while drunk-- later, he mistakes his desire to make up for the failure and to Fix things with a pretty woman he feels friendship for for romantic intentions, but he isn’t really put out by her preferring his best friend, he just isn’t good at navigating his own emotions when they pertain to others-- the social convention he understands is that he should be romantically interested in this girl, and so he tries to behave that way, and his happiness when she agrees to give him a second chance is genuine! However, he’s more upset about Fiscus borrowing his coat without asking than he is about his romance with Nurse Daniels. Even if he couldn’t personally parse this for himself, the important thing was fixing the friendly relationship he had with her before the disastrous date, and he accomplished that in a roundabout way when he made the effort to apologize and showed that he would rather just see her happy. He just never internalized that in a way that would help him see social success in other situations or with other women.

 

He’s frequently cowed by people-- not only Craig, but by friends, colleagues, patients, his next door neighbor… he doesn’t really know how to stand up for himself in most situations. When he does, it rarely comes off as it should from a man in his position. He’s used to not having a lot of social sway or acumen. He doesn’t pick up on cues from others, aimed at him or otherwise, very often-- and despite being as talkative as the next person most of the time, seems out of the loop with office gossip. And although he’s been shouted down by a patient before and gets physically attacked every time he’s on emergency room duty, none of this is to say he doesn’t have good bedside manner.

 

Actually, Victor Ehrlich has  _ excellent _ bedside manner. He’s friendly, he’s funny, he’s genuinely caring… The problem is, he’s not  _ supposed _ to. He’s a surgeon, his experience with bedside manner is meant to be limited-- certainly it’s not something Dr. Craig would approve of, his being too chummy with the patients when that’s the medical doctors’ job. He just can’t seem to help himself because while he’s not good socially, he  _ likes _ people and he wants to connect to them.

 

Despite the missteps and the times he suffers social punishments for the things others know to say sotto voce or only in certain company, the people around him mostly get that he’s a good guy underneath the weird out-of-place comments (and boy, are there weird out-of-place comments-- at one point, when the subject is Scandinavian foods, he jokingly tosses out ‘Norwegian Wood’ only to be stared at like he’s an ass, and that’s not the worst) or unthinking moments. He might get called out now and then, and he certainly gets shouted at often enough, and there are times when it seems as if he doesn’t quite believe it’s possible to come back from an argument, but relationships get repaired, upsets get smoothed over, and the people who know him mostly understand him. He’s not the most comforting person in the hospital, but he offers comfort when he knows it’s needed, and however inept he may be at it, his honest attempts are usually accepted as such. 

 

He’s frequently a little confused by simple conversations. He can speak in extended metaphor, but can’t understand metaphorical language coming from anyone else-- when he hurts his hand and Craig asks him what a surgeon’s most valuable tool is, it has to be spelled out for him, as he mentally catalogs all the literal tools he might use. He has difficulty putting himself in someone else’s shoes, such as when he and Morrison differ on how to treat a shared patient, and he fails to understand  _ why _ Morrison is upset with him for scheduling a surgery without talking it out with him. He’s afraid of being hurt at times-- has perhaps had friendships dangled in front of him and yanked away, and he’s definitely aware that he is easily manipulated, but it doesn’t make him any less so. He’s sometimes wary or uncertain, but a highly social animal at heart, he just doesn’t know how to be and often shoots himself in the foot trying.

 

\---/-/---

 

III. MANNERISMS

 

This man has some highly autistic mannerisms, and I’ll get to body language, but I want to start with something else.

 

I want to start with his wardrobe. 

 

Okay, I hear you, wardrobe isn’t exactly a mannerism. But there’s not really a better place to stick idiosyncratic dress. It’s not really a special interest, though there’s some crossover between the hawaiian shirt collection and his love of surfing. But for whatever reason, a lot of us on the spectrum can dress a little… differently. And Victor is no different. 

 

To be fair, weird ties and hawaiian shirts weren’t out of place in the 80s-- everything he wears is A-OK by the hospital dress code. It’s just that while another person might wear a hawaiian shirt now and then to be fun, or have a novelty tie he breaks out for parties, Victor wears a hawaiian shirt every day. Every day. Now, he’s not devoid of color sense even if his fashion sense is iffy-- the ties usually look good with the shirts! But a hawaiian shirt every day is a little out there, and a hawaiian shirt paired with a necktie and a  _ sweater vest _ is Weird with a capital W. He dances to the beat of his own drum. (He also has a pair of shoes that get roundly mocked, not only by his friends but by one of the older doctors. I’ll tell you what, though, I honestly love those shoes.)

 

It’s very difficult to describe all of the ways in which Victor’s body language reads as autistic to me, an autistic person myself. Not all of his mannerisms are mine by any means-- he doesn’t flap or flutter or rock back and forth. He holds himself very stiffly and awkwardly sometimes. He has moments of  _ emphatic _ physicality, not quite cartoonish, but brief little bursts of being too animated rather than too stiff. He emotes in a way which is highly familiar to me-- while most people still think of the flat affect when they think of the face of autism, the opposite is frequently true, too. People who go overboard in their expression. It’s completely genuine, it’s not putting on an expression or gesture in order to look less stiff and flat to others, it’s the way the things in you bubble up and come out and sometimes it’s too little and other times it’s too much. Victor is frequently Too Much, so slightly that the average person couldn’t pick it out as being an indicator of neurodivergence (and certainly not in his own time), but in a way that rings true to my own experience. 

 

I mentioned before that he occasionally reads as child-like, in moments where he’s being lectured/disciplined, and that’s definitely part of it. I wish that I had a better way of communicating this sort of thing than ‘child-like’, because of course as an autistic adult, I don’t really like the implication that we’re like children. We aren’t. Even in those moments, we’re adults with adult life experiences and feelings, but there’s an arrested development in the way emotions are processed, for many of us. Victor gets that with Dr. Craig in particular, but also has that shift in mannerisms with others. When he’s being dressed down by Jack Morrison, he goes from little-boy-called-to-the-carpet to adult frustration when he’s alone. The off-ness in his mannerisms is highlighted again when the two of them make up-- there’s something about the handshake he gives which is just a little Too Much, a little more than it has to be, but which is very earnest.

 

I think that’s part of what comes across as child-like, even though it isn’t the whole picture-- Victor has an intense  _ earnestness _ to him when he isn’t putting on the One Of The Guys act. When he is emotionally, honestly himself, it is a physical part of him. He shows too much of what he feels, he doesn’t shutter any of himself off. He holds on too long. It means too much to him to be made up with. He is trusting-- he is trusting with everyone. When Chandler or Armstrong give him advice, when Fiscus makes another promise he’s going to break, when he seeks Vijay’s opinion… he doesn’t really hold any of himself back. 

 

He is, as mentioned, literal-minded. He follows the Rules, or what he suspects might be Rules, and when a Rule is broken-- like patients sleeping in the on call room-- he has a difficult time. He claims at one point that being from California, he’s not totally uncool when it comes to drugs, but it comes across as painfully untrue-- UC Berkley in the sixties and beach bumming around Malibu or not, he’s never been ‘cool’ about drugs. When it’s suggested that he use amphetamines to get through surgery when he’s already been awake too many hours to make it, he refuses point blank to touch them-- on the reasonable grounds that they would make his hands shake. Later, he’s affronted at the idea that he would carry uppers on him (it was vitamin E). Medical knowledge and the need to be rule-abiding outweighed the social pressure of the time and place that he grew up and attended college, but it’s difficult to picture the guy getting offended over the suggestion that he might pop a pill in an emergency as someone who was ever ‘cool’ where drugs are concerned. 

 

Victor can’t handle mess. This is what leads to a lot of the friction when Fiscus moves in with him, but it isn’t only messiness-- it’s order. He’s self-admittedly very, very particular about things. And we see how terrible he is when things are not ordered-- during the Legionnaires’ outbreak, he’s the most upset over the disorganization and crowding. He starts getting stressed and shouty and very upset when charts are misplaced and when bodies are all over the place instead of neatly organized in waiting rooms and beds in wards and when people crowd him, and Victor shouting isn’t like Dr. Craig shouting, Victor is just desperate for the situation to be _ remedied _ , and it’s not happening. It’s not a full-on meltdown, but he’s a man on the verge. And as far as mess and order and living with Fiscus goes, he can’t even  _ watch _ the man eat when he’s stolen Victor’s favorite shirt, the possibility of a spill is too much for him to bear. He’s exacting about how he likes things at work, at home, in his bookkeeping-- he tells a patient he wants to get married for tax purposes, and I’m not so sure he’s joking.

 

He’s not always good at thinking through consequences-- after he injures his hand while being careless on the handball court, he jams it in an elevator door without a second thought (before absorbing the new Rule that Craig has set regarding hand-safety, and proceeding to irritate everyone in his quest to protect himself). He doesn’t know a thing about football, and can’t fake an interest in any sport but his own. He says things like ‘peachy keen’ as if it’s completely natural to him to do so. He is a strange guy in so many little ways, in how he processes and interacts with the world, and in how he presents himself, whether he means to present himself any particular way or not. There are so many moments in my notes, honestly, where all I have down is ‘SO AUTISTIC’, about a moment I have difficulty really explaining, but suffice to say, Victor really reads true to my own experiences. 

 

\---/-/---

 

IV. SPECIAL AREAS OF INTEREST

 

I mean, right off the bat,  _ surgery _ . It’s not just that this is what he wants to do with his life, not just that he enjoys studying for and doing his job, it’s that if he couldn’t be a surgeon, he wouldn’t want to be any other kind of doctor. It’s that he couldn’t be in this environment and not be able to do surgery. And when he’s not doing his job or studying for his job, he’s the character who is most often heard discussing other surgeries he wasn’t involved in. He even enjoys observing promising-sounding surgeries, in one episode asking some of the others if they wanted to go view a really gory one.

 

After surgery, Victor Ehrlich’s main interest is surfing-- something he’s not going out and engaging in as often as he used to back in California, perhaps, but which remains a consuming passion. He speaks in surfing metaphors, daydreams about surfing when sleep deprived, and it isn’t just the sport itself-- it’s the big novelty tie with the palm trees painted on it and the surf rock record collection (everything by the Beach Boys, just to start), and I am going to skip forward a little bit into s2 to be able to mention his relying on this special area of interest to keep him calm during a blood draw, where he rattles off surfing terms to himself. 

 

He’s committed to playing handball, but it’s not on the level of surfing and surgery as far as special areas of interest go, or doesn’t seem to be. I’m going to give Trivial Pursuit an honorable mention-- it is not, in and of itself, a special interest, but look… I do not know  _ any  _ non-Autistic people who get super into Trivial Pursuit, and when he’s got that card in his hand, it’s  _ important _ .

 

Victor’s special interests are vital to him-- they inform who he is as a character for the audience, but from a Watsonian perspective, these are the things that get him through the day. If he didn’t feel the way that he feels about surgery, would he have the same career path? He might be unsuccessful or unhappy, forcing himself through a different path, or simply less passionate and less fulfilled. Certainly to anyone he successfully operates on, his interest in surgery is important. It’s made him very good at what he does, and it’s made him someone who is willing to face the rigors of long, punishing shifts, of a demanding boss and mentor, to better himself constantly. And while his passion for surgery has led to career skills, his passion for surfing gives him something else-- this is the comfort interest, the thing he can turn to when the stresses really mount, the thing that even when he cannot engage in the activity, he can go to it for a sense of inner peace. That’s one of the reasons our special interests are important, they help with emotional regulation. 

 

In conclusion, Victor Ehrlich is really, really, incredibly autistic. Thank you.


End file.
